Etiology and incidence of rehospitalization after traumatic spinal cord injury: A multicenter analysis11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

Cardenas, Diana D.; Hoffman, Jeanne M.; Kirshblum, Steven; McKinley, William

doi:10.1016/j.apmr.2004.03.016

Cited by 387 publications

(82 citation statements)

References 9 publications

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“…Percentage of males was 83.9, with a male-to female ratio similar to world data. In United States of America, approximately 18-33% of patients with SCI were female and 67-82% were male (16, 17). Mean age for SCI has been reported as 37 ± 11.5 years worldwide (18, 19) and 35.9 years in the United States (8).…”

Section: Discussionmentioning

confidence: 99%

The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients

Togan

Azap

Durukan

et al. 2014

Jundishapur J Microbiol

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Background:Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days.Objectives:The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury.Patients and Methods:This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuriaResults:Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant.Conclusions:The most common infectious episode among spinal cord injury patients was found to be urinary tract ınfection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract ınfection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.

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Section: Discussionmentioning

confidence: 99%

The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients

Togan

Azap

Durukan

et al. 2014

Jundishapur J Microbiol

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“…Respiratory infections are among the three most common causes of rehospitalization within one year of spinal cord injury [5]. As well, longitudinal studies have identified an association of diseases of the respiratory tract as the cause of rehospitalization in tetraplegia during 20 years following acute traumatic spinal cord injury [6]. The occurrence of pneumonia in the acute severe traumatic spinal cord injury patient has been associated with worse neurologic outcome one year after injury and consideration of the use of preventative measures has been suggested [7].…”

Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure (CPAP) for prevention of recurrent pneumonia in the Neuromyelitis Optica patient

Welker

2014

Respiratory Medicine Case Reports

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IntroductionTraumatic spinal cord injury patients with quadriplegia associated respiratory compromise are at an immediately increased risk of developing pneumonia, but the onset of pneumonia risk and use of prevention strategies in the patient with quadriplegia due to Neuromyelitis Optica has not been described.Case reportThis is a case of a Neuromyelitis Optica patient with quadriplegia, dysphagia and tracheostomy that suffered recurrent fevers due to respiratory infections. The non-specific presentation and test results led to extensive testing, while the frequent recurrence resulted in the patient residing in the acute care hospital 201 days and outside of this hospital only 118 days during the period of August 2011 to June 2012. The initiation of CPAP 10 cm while sleeping overnight for 8–10 h eliminated the recurrence of respiratory infections and thereby reduced both the frequency and duration of the patient's hospital stays.ConclusionsPatients with Neuromyelitis Optica differ from those with traumatic spinal cord injury as they have a chronic progressive systemic illness that causes continued deterioration of their nervous system resulting in the need for routine monitoring that ensures the timely addition of CPAP for the prevention of pneumonia and its associated medical expenses.

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“…These include respiratory complications, pressure ulcers, and obesity. SCI/D causes physiological changes that increase the risks of respiratory complications and illnesses [12][13], which are leading causes of death [14] and hospitalizations after SCI/D [15]. To decrease respiratory complications, SCI QUERI researchers have implemented strategies to increase influenza vaccinations [16][17] and have examined trends (antibiotic prescription) and outcomes in respiratory conditions [18][19][20].…”

Section: Strategies For Studying Complications Of Sci/d: Lessons Frommentioning

confidence: 99%

Using VA data for research in persons with spinal cord injuries and disorders: Lessons from SCI QUERI

Smith

Evans²,

Ullrich

et al. 2010

JRRD

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Abstract-The Department of Veterans Affairs (VA) provides integrated services to more than 25,000 veterans with spinal cord injuries and disorders (SCI/D). VA data offer great potential for providing insights into healthcare utilization and morbidity, and these capabilities are central to efforts to improve healthcare for veterans with SCI/D. The objective of this article is to introduce researchers to the use of VA data to examine questions related to SCI/D using examples from Spinal Cord Injury (SCI) Quality Enhancement Research Initiative studies. Sources of VA data available to investigators interested in SCI/Drelated research include national-level VA administrative and clinical databases and primary data (medical record review, patient surveys). Methods used to identify veterans with SCI/D include the Allocation Resource Center cohort, the Spinal Cord Dysfunction (SCD) Registry, and the VA inpatient SCI flag; only 33% of veterans were included in all three groups (n = 12,306). While neurological level of SCI was unknown for approximately a third of veterans (from SCD Registry data alone), the percent decreased to 13% when augmented with diagnostic codes. Primary data can be used to augment other missing SCI data and to provide more detailed information about complications commonly associated with SCI/D.

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Cited by 387 publications

References 9 publications

The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients

The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients

Continuous Positive Airway Pressure (CPAP) for prevention of recurrent pneumonia in the Neuromyelitis Optica patient

Using VA data for research in persons with spinal cord injuries and disorders: Lessons from SCI QUERI

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